In current practice, diagnostic parameters, such as fractional flow reserve (FFR) and coronary flow reserve (CFR), are used to determine the severity of a coronary artery stenosis. FFR is defined as the ratio of hyperemic pressures distal () and proximal () to a stenosis. CFR is the ratio of flow at hyperemic and basal condition. Another diagnostic parameter suggested by our group is the pressure drop coefficient (CDP). CDP is defined as the ratio of the pressure drop across the stenosis to the upstream dynamic pressure. These parameters are evaluated by invasively measuring flow (CFR), pressure (FFR), or both (CDP) in a diseased artery using guidewire tipped with a sensor. Pathologic state of artery is indicated by lower CFR (<2). Similarly, FFR lower than 0.75 leads to clinical intervention. Cutoff for CDP is under investigation. Diameter and vascular condition influence both flow and pressure drop, and thus, their effect on FFR and CDP was studied. In vitro experiment coupled with pressure-flow relationships from human clinical data was used to simulate pathophysiologic conditions in two representative arterial diameters, 2.5 mm (N1) and 3 mm (N2). With a 0.014 in. (0.35 mm) guidewire inserted, diagnostic parameters were evaluated for mild (∼64% area stenosis (AS)), intermediate (∼80% AS), and severe (∼90% AS) stenosis for both N1 and N2 arteries, and between two conditions, with and without myocardial infarction (MI). Arterial diameter did not influence FFR for clinically relevant cases of mild and intermediate stenosis (difference < 5%). Stenosis severity was underestimated due to higher FFR (mild: ∼9%, intermediate: ∼ 20%, severe: ∼ 30%) for MI condition because of lower pressure drops, and this may affect clinical decision making. CDP varied with diameter (mild: ∼20%, intermediate: ∼24%, severe: by 2.5 times), and vascular condition (mild: ∼35%, intermediate: ∼14%, severe: ∼ 9%). However, nonoverlapping range of CDP allowed better delineation of stenosis severities irrespective of diameter and vascular condition.
Skip Nav Destination
Mechanical Engineering Program,
University of Cincinnati,
California Institute of Technology,
Pasadena, CA 91125
Mechanical Engineering Program,
University of Cincinnati,
Cincinnati, OH 45221
e-mail: Rupak.banerjee@uc.edu
Article navigation
September 2013
Research-Article
Influence of Variable Native Arterial Diameter and Vasculature Status on Coronary Diagnostic Parameters
Marwan F. Al-Rjoub,
Mechanical Engineering Program,
University of Cincinnati,
Marwan F. Al-Rjoub
School of Dynamic Systems
,Mechanical Engineering Program,
University of Cincinnati,
Cincinnati
, OH 45221
Search for other works by this author on:
Lloyd H. Back,
California Institute of Technology,
Pasadena, CA 91125
Lloyd H. Back
Jet Propulsion Laboratory
,California Institute of Technology,
Pasadena, CA 91125
Search for other works by this author on:
Rupak K. Banerjee
Mechanical Engineering Program,
University of Cincinnati,
Cincinnati, OH 45221
e-mail: Rupak.banerjee@uc.edu
Rupak K. Banerjee
1
School of Dynamic Systems
,Mechanical Engineering Program,
University of Cincinnati,
Cincinnati, OH 45221
e-mail: Rupak.banerjee@uc.edu
1Corresponding author.
Search for other works by this author on:
Marwan F. Al-Rjoub
School of Dynamic Systems
,Mechanical Engineering Program,
University of Cincinnati,
Cincinnati
, OH 45221
Lloyd H. Back
Jet Propulsion Laboratory
,California Institute of Technology,
Pasadena, CA 91125
Rupak K. Banerjee
School of Dynamic Systems
,Mechanical Engineering Program,
University of Cincinnati,
Cincinnati, OH 45221
e-mail: Rupak.banerjee@uc.edu
1Corresponding author.
Contributed by the Bioengineering Division of ASME for publication in the Journal of Biomechanical Engineering. Manuscript received October 13, 2012; final manuscript received May 13, 2013; accepted manuscript posted May 31, 2013; published online July 10, 2013. Assoc. Editor: Hai-Chao Han.
J Biomech Eng. Sep 2013, 135(9): 091005 (8 pages)
Published Online: July 10, 2013
Article history
Received:
October 13, 2012
Revision Received:
May 13, 2013
Accepted:
May 31, 2013
Citation
Goswami, I., Peelukhana, S. V., Al-Rjoub, M. F., Back, L. H., and Banerjee, R. K. (July 10, 2013). "Influence of Variable Native Arterial Diameter and Vasculature Status on Coronary Diagnostic Parameters." ASME. J Biomech Eng. September 2013; 135(9): 091005. https://doi.org/10.1115/1.4024682
Download citation file:
Get Email Alerts
Cited By
Related Articles
Diagnostic Uncertainties During Assessment of Serial Coronary Stenoses: An In Vitro Study
J Biomech Eng (February,2014)
Reduced Order Models for Transstenotic Pressure Drop in the Coronary Arteries
J Biomech Eng (March,2019)
An Experimentally Validated Model for Two-Phase Pressure Drop in the Intermittent Flow Regime for Circular Microchannels
J. Fluids Eng (March,2002)
Pressure Measurements in a Wire-Wrapped 61-Pin Hexagonal Fuel Bundle
J. Fluids Eng (March,2018)
Related Proceedings Papers
Related Chapters
Extended-Surface Metallurgy
Heat Exchanger Engineering Techniques
Performance Testing of Combined Cycle Power Plant
Handbook for Cogeneration and Combined Cycle Power Plants, Second Edition
The Special Characteristics of Closed-Cycle Gas Turbines
Closed-Cycle Gas Turbines: Operating Experience and Future Potential